目的:本研究旨在分析儿童由肠道病毒(EV)和/或人副病毒(HPeV)感染引起的临床表现,以及澳大利亚一家地区医院收治的此类病例的管理。
方法:回顾病历的回顾性研究。
方法:澳大利亚地区的单一医院。
方法:从2017年1月1日开始的5年期间,所有18岁以下儿童入院,确诊为EV和/或HPeV感染。排除具有临床上不显著的EV/HPeV分离的病例。
方法:收集的数据包括人口统计数据,存在的体征和症状,EV/HPeV分离标本,共同发生的病原体,峰值C反应蛋白(CRP),抗生素治疗,出院诊断及出院后随访。
结果:总体而言,27例患者符合纳入标准;81.5%的患者年龄≤3个月,中位数为2个月(四分位距1-3);74.1%为男性。最常见的临床特征是发烧≥38°C和易怒/嗜睡/高声哭泣。29.6%的患者检出共现病原体,77.8%的病例CRP≤10mg/L。除两个孩子外,所有孩子都在等待聚合酶链反应结果时接受了抗生素治疗。最常见的出院诊断是脑膜炎。总之,74.1%的儿童参加了后续预约。
结论:EV和HPeV应被认为是3个月以下儿童发热和易怒/嗜睡/高声哭闹的可能病因。
OBJECTIVE: This study aims to analyse the clinical presentation caused by enterovirus (EV) and/or human parechovirus (HPeV) infection in children, as well as the management of such cases admitted to a regional hospital in Australia.
METHODS: Retrospective study reviewing medical records.
METHODS: Single hospital in regional Australia.
METHODS: All children under 18 years admitted over the 5-year period beginning from 1 January 2017 with confirmed EV and/or HPeV infection. Cases with clinically insignificant EV/HPeV isolation were excluded.
METHODS: Data collected included demographic data, signs and symptoms present, specimens of EV/HPeV isolation, co-occurring pathogens, peak C-reactive protein (CRP), antibiotic therapy, discharge diagnosis and follow-up after discharge.
RESULTS: Overall, 27 patients fulfilled the inclusion criteria; 81.5% of the patients were ≤3 months of age with a median of 2 months (interquartile range 1-3); 74.1% were males. The most common clinical features were a fever ≥38°C and irritability/lethargy/high-pitched cry. 29.6% of the patients had co-occurring pathogens detected, and a CRP ≤10 mg/L was observed in 77.8% of cases. All but two children were treated with antibiotics while awaiting polymerase chain reaction results. The most common discharge diagnosis was meningitis. In all, 74.1% of the children attended follow-up appointments.
CONCLUSIONS: EV and HPeV should be considered as a possible aetiology of fever and irritability/lethargy/high-pitched cry in children under 3 months.